Ankylosing Spondylitis — SCE Rheumatology MCQ

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ModerateSpondyloarthropathyAnkylosing SpondylitisSCE Rheumatology

A 42-year-old man with axial SpA on Etanercept has achieved ASDAS inactive disease (<1.3) for 18 months. He wishes to stop treatment entirely. What is the expected outcome based on BSR 2025 guidance?

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Correct answer: E — Most patients will relapse after complete withdrawal but respond to re-treatment

BSR 2025 axSpA guidelines state that most patients who completely withdraw targeted therapy will experience relapse. However, re-treatment is usually effective in recapturing response. Gradual dose reduction (extending the dosing interval) is recommended before considering complete withdrawal. The decision should be shared with the patient, considering individual risk factors for relapse and patient preferences. Methotrexate has no role in axial SpA maintenance.

Reference: BSR 2025 - Guideline for treatment of axSpA with biologic and targeted synthetic DMARDs